Prevention of Fetal Alcohol Spectrum Disorders: Practice Behaviors, Attitudes, and Confidence among Members of the American College of Nurse-Midwives

As part of an ACNM collaboration with the Centers for Disease Control and Prevention (CDC) and its partners and grantees on a project to prevent fetal alcohol spectrum disorders (FASDs), ACNM members were surveyed to generate an assessment of practice behaviors of certified nurse-midwives and certified midwives related to the prevention of FASDs. The information will be used as a baseline from which to measure change in nurse-midwives’ and midwives’ practice behaviors over the course of the project. Results from the assessment will also be used to inform detailed collaborative activities between ACNM and CDC grantees whose efforts specifically target nurse-midwives (i.e., University of Alaska Anchorage (UAA), University of California San Diego, University of Pittsburgh).This report was supported by Cooperative Agreement Numbers DD001143 (University of Alaska Anchorage), DD001144 (University of California, San Diego), and DD001035 (University of Pittsburgh, School of Nursing), funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Service

Medicaid Policies for Alcohol SBI Reimbursement

The purpose of this report was to review existing reimbursement policies by state Medicaid agency, including the District of Columbia (D.C.), in order to understand similarities and differences associated with financial compensation for alcohol screening and brief intervention (SBI) services. Alcohol SBI is an evidence-based practice known to help reduce atrisk alcohol consumption among patients who drink too much. 1 Although alcohol SBI was designed to be a population-based approach to address unhealthy alcohol consumption, its current utilization is limited. 2 Implementation of the practice into routine clinical care remains a challenge at the health system level even with support from federal resources (e.g., SBIRT: Screening, Brief Intervention, and Referral to Treatment). One way to encourage the uptake of alcohol SBI/SBIRT among providers is to ensure that the service is reimbursable by third-party payers. However, reimbursement opportunities vary by state and payer, and in some locations are non-existent. Information about the current status of policies will assist in the development of policies and incentives to encourage healthcare providers and systems to submit claims for alcohol SBI/SBIRT and potentially increase the routine uptake of the service in clinical careCenters for Disease Control and Prevention Cooperative Agreement Number DD00114

A Correlational Study on Critical Thinking in Nursing as an Outcome Variable for Success

Critical thinking is a required curricular outcome for nursing education; however, the literature shows a gap related to valid and reliable tools to measure critical thinking specific to nursing and relating that critical thinking measurement to meaningful outcomes. This study examined critical thinking scores, as measured by Assessment Technologies Institute (ATI) Critical Thinking Exam (CTE), to determine if a statistically significant predictive association existed between critical thinking scores, successful Associate of Science in Nursing (ASN) program completion, and National Certification Licensure Examination for Registered Nurses (NCLEX-RN®) pass rates. The research was conducted in a semi-urban, hospital-based, ASN program and included 550 students obtained by convenience sampling in a retrospective, predictive correlational study. Logistical analysis was conducted to determine if any relationships existed between the variables of interest while controlling for confounding variables such as nursing course grade point average (GPA) and preadmission ATI Test of Essential Academic Skills (TEAS) scores. Critical thinking was found to be a positive predictor of student success [program completion (p = .012); NCLEX success (p = .002)] as were TEAS [program completion (p = .003); NCLEX success (p = .001)] and nursing course GPA [NCLEX success (p = .001)]. However, cumulative effects for the three variables were not found to increase the predictive power of the model and none of the variables were deemed good predictors of failure

(In)security groups and governance in Gulu, Uganda

Last November, at three in the morning, a man was murdered on the street not far outside Gulu Town. There were tens of witnesses, yet there was no investigation, no prosecution, and no compensation provided to the victim’s family. A common reflection on the event was that the victim “did good to die”

Palliative and end-of-life care in the home in regional/rural Victoria, Australia : the role and lived experience of primary carers

Introduction: Palliative support services (generalist or specialist) can provide much-needed assistance to carers who are providing palliative and end-of-life care in their homes, but access to such services in regional and rural areas of Australia is poorly understood. Objectives: This study aimed to explore the role and lived experience of primary carers who are providing palliative and end-of-life care in the home in regional/rural Victoria, Australia. Methods: Nine female participants, of whom six were bereaved between 7 and 20 months were interviewed using a semistructured interview technique. Each interview was audio-recorded, transcribed verbatim, and analyzed thematically. Results: Two themes emerged: “Negotiating healthcare systems” which described the needs for multidisciplinary supports and “The caring experience” which discussed daily tasks, relationships, mental and physical exhaustion, respite, isolation, medication management, and grief and loss. Findings show that regional/rural carers have an added burden of travel stress as well as feeling overwhelmed, isolated, and physically and emotionally exhausted. Carers would benefit from greater flexibility for short-term respite care. The engagement of specialist palliative care services assisted the participants to navigate the health care system. Some participants did not understand the value of palliative care, highlighting the need for general practitioners to conduct early conversations about this with their patients. Education is needed to build capacity within the primary palliative care workforce, confirming the importance of timely referrals to a specialist palliative care practitioner if pain or symptom control is not effectively managed. Conclusion: Providing palliative and end-of-life care in the home is an exhausting and emotionally draining role for unpaid, primary carers. Multiple supports are needed to sustain primary carers, as they play an essential role in the primary health care system. © The Author(s) 2021

Acceptability, Use, and Safety of a Mobile Phone App (BlueIce) for Young People Who Self-Harm: Qualitative Study of Service Users’ Experience

Background: Self-harm is common among adolescents and is associated with a number of negative psychosocial outcomes including a higher risk of suicide. Recent reviews highlight the lack of research into specific interventions for children and young people who self-harm. Developing innovative interventions that are coproduced with individuals with lived experience and that reduce self-harm are key challenges for self-harm prevention. Objective: The aim of this study was to explore the acceptability, use, and safety of BlueIce, a mobile phone app for young people who self-harm and who are attending child and adolescent mental health services (CAMHS). Methods: This study is part of a mixed methods phase 1 trial of BlueIce. Young people aged 12-17 years attending specialist CAMHS were recruited. Clinicians were invited to refer young people who were self-harming or who had a history of self-harm. On consent being obtained and baseline measures taken, participants used BlueIce as an adjunct to usual care for an initial familiarization period of 2 weeks. If after this time they wanted to continue, they used BlueIce for a further 10 weeks. Semistructured interviews were conducted at postfamiliarization (2 weeks after using BlueIce) and postuse (12 weeks after using BlueIce) to assess the acceptability, use, and safety of BlueIce. We undertook a qualitative analysis using a deductive approach, and then an inductive approach, to investigate common themes. Results: Postfamiliarization interviews were conducted with 40 participants. Of these, 37 participants elected to use BlueIce, with postuse interviews being conducted with 33 participants. Following 6 key themes emerged from the data: (1) appraisal of BlueIce, (2) usability of BlueIce, (3) safety, (4) benefits of BlueIce, (5) agency and control, and (6) BlueIce less helpful. The participants reported that BlueIce was accessible, easy to use, and convenient. Many highlighted the mood diary and mood lifter sections as particularly helpful in offering a way to track their moods and offering new strategies to manage their thoughts to self-harm. No adverse effects were reported. For those who did not find BlueIce helpful, issues around motivation to stop self-harming impeded their ability to use the app. Conclusions: BlueIce was judged to be a helpful and safe way of supporting adolescents to manage thoughts of self-harming. Adolescents reported numerous benefits of using BlueIce, and all would recommend the app to other young people who were struggling with self-harm. These preliminary findings are encouraging and provide initial support for the acceptability of BlueIce as a self-help intervention used in conjunction with the traditional face-to-face therapy

In vivoresponse of GsdmA3Dfl/+ mice to topically applied fish oil - effects on cellular markers and macrophages

Psoriasis is an incurable autoimmune disease characterized by patches of abnormal red, itchy and scaly skin. This work examined the modulation of inflammation, hyperproliferation and immune cell markers following topical application of fish oil (FO) in comparison to the antipsoriatic agents, betamethasone dipropionate (BD) and salicylic acid (SA), to GsdmA3Dfl/+ mice, a hair loss mutant which also exhibits epidermal hyperproliferation akin to psoriasis. The mice were dosed with 100 mg of the test formulation and after 10 days, the mice were sacrificed, skin sections excised and subjected to immunohistochemical determination of COX-2, K17 and MAC-1; and immunofluorescence of Ki-67. Unchanged expression of the proinflammatory enzyme COX-2 was observed in all treatments, suggesting the noninvolvement of COX-2 in the aetiology of cutaneous aberration seen in GsdmA3Dfl/+ mice. Intense staining of K17 and MAC-1 in the FO-treated group mirrored the epidermal thickening seen observed in live mice by optical coherence tomography (OCT). The ratio of Ki-67-positive nuclei per 100 basal cells indicated that hyperproliferation of keratinocytes occurred in FO-treated mice and the opposite was true for BD-treated mice. There was a positive correlation (R2 0.995) between Ki-67 and the epidermal thickness data observed previously. In all immunochemical procedures, the combined BD, SA and FO formulation did not show any significant difference with the control group, reflecting observations seen previously. In conclusion, the epidermal changes observed following topical FO treatment on GsdmA3Dfl/+ mice involves an increase in cellular proliferation and macrophages, although COX-2 does not appear to play an important role

Leading and Managing Those Working and Living in Captive Environments

I magine you are the warden of a prison or the administrator of a jail, you enter the facility, and the heavy metal door clangs shut behind you. A riot breaks out and several members of your staff are taken hostage. Fires are set in various locations. The rioting inmates, members of a gang, attack other inmates who want no part in the rebellion and are only concerned for their safety. The decisions you as a leader make are literally matters of life or death, not only for yourself, but also for your staff and those incarcerated. The dynamics of power and guarding against potential corruption are also a constant concern. The leader of an incarceration facility must account for and respond to public opinion and political demands, as well as the individual needs and group dynamics of corrections officers and inmates. Some of the desired outcomes for leaders in a confinement setting are a reduction in recidivism, security of the facility, prevention of escape, and efforts at rehabilitation. While some would argue that depending upon the reason for incarceration, the inmates do not deserve much more consideration than would an animal in a zoo, others-leaders-in this situation strive for much more. Accomplished leaders in a confinement setting seek to develop a culture that creates and sustains the psychological health and well-being of the corrections officers and provides inmates opportunities to develop skills and their potential. After all, they are in the people business. Such an approach would conceivably result in an institution that functions based on the strengths of the corrections officers and inmates, thereby allowing them the greatest opportunity for self-development, physical and psychological security, and indirectly decreased chances of recidivism. This chapter discusses the contexts of confinement, the psychology of corrections officers and inmates, and the forces at work on a leader and the population being led

The power of naked protest in a shrinking democratic space

Even while new technologies transform political protest, citizens continue to use their bodies in acts of civil resistance. In northern Uganda, citizens are using public nakedness to protest land dispossession by an increasingly authoritarian state, which grants the protester forms of power and highlights constraints on political speech

Leading and Managing Those Working and Living in Captive Environments

I magine you are the warden of a prison or the administrator of a jail, you enter the facility, and the heavy metal door clangs shut behind you. A riot breaks out and several members of your staff are taken hostage. Fires are set in various locations. The rioting inmates, members of a gang, attack other inmates who want no part in the rebellion and are only concerned for their safety. The decisions you as a leader make are literally matters of life or death, not only for yourself, but also for your staff and those incarcerated. The dynamics of power and guarding against potential corruption are also a constant concern. The leader of an incarceration facility must account for and respond to public opinion and political demands, as well as the individual needs and group dynamics of corrections officers and inmates. Some of the desired outcomes for leaders in a confinement setting are a reduction in recidivism, security of the facility, prevention of escape, and efforts at rehabilitation. While some would argue that depending upon the reason for incarceration, the inmates do not deserve much more consideration than would an animal in a zoo, others-leaders-in this situation strive for much more. Accomplished leaders in a confinement setting seek to develop a culture that creates and sustains the psychological health and well-being of the corrections officers and provides inmates opportunities to develop skills and their potential. After all, they are in the people business. Such an approach would conceivably result in an institution that functions based on the strengths of the corrections officers and inmates, thereby allowing them the greatest opportunity for self-development, physical and psychological security, and indirectly decreased chances of recidivism. This chapter discusses the contexts of confinement, the psychology of corrections officers and inmates, and the forces at work on a leader and the population being led